[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[S. 2562 Introduced in Senate (IS)]
<DOC>
114th CONGRESS
2d Session
S. 2562
To support a comprehensive public health response to the heroin and
prescription drug abuse crisis.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
February 22, 2016
Mr. Brown (for himself and Ms. Baldwin) introduced the following bill;
which was read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To support a comprehensive public health response to the heroin and
prescription drug abuse crisis.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Heroin and
Prescription Drug Abuse Prevention and Reduction Act''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--PREVENTION
Sec. 101. Practitioner education.
Sec. 102. Co-prescribing opioid overdose reversal drugs grant program.
Sec. 103. Opioid overdose reversal co-prescribing guidelines.
Sec. 104. Surveillance capacity building.
TITLE II--CRISIS
Sec. 201. Grants to support syringe exchange programs.
Sec. 202. Grant program to reduce drug overdose deaths.
TITLE III--TREATMENT
Sec. 301. Expansion of patient limits under waiver.
Sec. 302. Definitions.
Sec. 303. Evaluation by assistant Secretary for planning and
evaluation.
Sec. 304. Reauthorization of residential treatment programs for
pregnant and postpartum women.
Sec. 305. Pilot program grants for State substance abuse agencies.
Sec. 306. Evidence-based opioid and heroin treatment and interventions
demonstration.
Sec. 307. Grants to improve access to treatment and recovery for
adolescents.
Sec. 308. Strengthening parity in mental health and substance use
disorder benefits.
Sec. 309. Study on treatment infrastructure.
Sec. 310. Substance use disorder professional loan repayment program.
TITLE IV--RECOVERY
Sec. 401. National youth recovery initiative.
Sec. 402. Grants to enhance and expand recovery support services.
TITLE I--PREVENTION
SEC. 101. PRACTITIONER EDUCATION.
(a) Education Requirements.--
(1) Registration consideration.--Section 303(f) of the
Controlled Substances Act (21 U.S.C. 823(f)) is amended by
inserting after paragraph (5) the following:
``(6) The applicant's compliance with the training
requirements described in subsection (g)(3) during any previous
period in which the applicant has been subject to such training
requirements.''.
(2) Training requirements.--Section 303(g) of the
Controlled Substances Act (21 U.S.C. 823(g)) is amended by
adding at the end the following:
``(3)(A) To be registered to prescribe or otherwise dispense
opioids for the treatment of pain, or pain management, a practitioner
described in paragraph (1) shall comply with the 12-hour training
requirement of subparagraph (B) at least once during each 3-year period
or the requirements of a State training program approved by the
Secretary of Health and Human Services under subparagraph (C).
``(B) The training requirement of this subparagraph is that the
practitioner has completed not less than 12 hours of training (through
classroom situations, seminars at professional society meetings,
electronic communications, or otherwise) with respect to--
``(i) the treatment and management of opioid-dependent
patients;
``(ii) pain management treatment guidelines; and
``(iii) early detection of opioid addiction, including
through such methods as Screening, Brief Intervention, and
Referral to Treatment (SBIRT),
that is provided by the American Society of Addiction Medicine, the
American Academy of Addiction Psychiatry, the American Medical
Association, the American Osteopathic Association, the American
Psychiatric Association, the American Academy of Pain Management, the
American Pain Society, the American Academy of Pain Medicine, the
American Board of Pain Medicine, the American Society of Interventional
Pain Physicians, or any other organization that the Secretary
determines is appropriate for purposes of this subparagraph.
``(C) The Secretary of Health and Human Services may approve a
State training program that practitioners described in paragraph (1)
may comply with in lieu of compliance with the training program
provided for in subparagraph (B).''.
(b) Funding.--The Drug Enforcement Administration shall fund the
enforcement of the requirements specified in section 303(g)(3) of the
Controlled Substances Act (as added by subsection (a)) through the use
of a portion of the licensing fees paid by controlled substance
prescribers under the Controlled Substances Act (21 U.S.C. 801 et
seq.).
(c) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $1,000,000 for each of fiscal
years 2017 through 2021.
SEC. 102. CO-PRESCRIBING OPIOID OVERDOSE REVERSAL DRUGS GRANT PROGRAM.
(a) Establishment.--
(1) In general.--Not later than six months after the date
of the enactment of this Act, the Secretary of Health and Human
Services shall establish, in accordance with this section, a
four-year co-prescribing opioid overdose reversal drugs grant
program (in this title referred to as the ``grant program'')
under which the Secretary shall provide not more than a total
of 12 grants to eligible entities to carry out the activities
described in subsection (c).
(2) Eligible entity.--For purposes of this section, the
term ``eligible entity'' means a federally qualified health
center (as defined in section 1861(aa) of the Social Security
Act (42 U.S.C. 1395x(aa))), an opioid treatment program under
part 8 of title 42, Code of Federal Regulations, or section
303(g) of the Controlled Substances Act (21 U.S.C. 823(g)), a
program approved by a State substance abuse agency, or any
other entity that the Secretary deems appropriate.
(3) Co-prescribing.--For purposes of this title, the term
``co-prescribing'' means, with respect to an opioid overdose
reversal drug, the practice of prescribing such drug in
conjunction with an opioid prescription for patients at an
elevated risk of overdose, or in conjunction with an opioid
agonist approved under section 505 of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 355) for the treatment of opioid
abuse disorders, or in other circumstances in which a provider
identifies a patient at an elevated risk for an intentional or
unintentional drug overdose from heroin or prescription opioid
therapies. For purposes of the previous sentence, a patient may
be at an elevated risk of overdose if the patient meets the
criteria under the existing co-prescribing guidelines that the
Secretary deems appropriate, such as the criteria provided in
the Opioid Overdose Toolkit published by the Substance Abuse
and Mental Health Services Administration.
(b) Application.--To be eligible to receive a grant under this
section, an eligible entity shall submit to the Secretary of Health and
Human Services, in such form and manner as specified by the Secretary,
an application that describes--
(1) the extent to which the area to which the entity will
furnish services through use of the grant is experiencing
significant morbidity and mortality caused by opioid abuse;
(2) the criteria that will be used to identify eligible
patients to participate in such program; and
(3) how such program will work to try to identify State,
local, or private funding to continue the program after
expiration of the grant.
(c) Use of Funds.--An eligible entity receiving a grant under this
section may use the grant for any of the following activities:
(1) To establish a program for co-prescribing opioid
overdose reversal drugs, such as naloxone.
(2) To train and provide resources for health care
providers and pharmacists on the co-prescribing of opioid
overdose reversal drugs.
(3) To establish mechanisms and processes, consistent with
applicable Federal and State privacy rules, for tracking
patients participating in the program described in paragraph
(1) and the health outcomes of such patients.
(4) To purchase opioid overdose reversal drugs for
distribution under the program described in paragraph (1).
(5) To offset the co-pays and other cost sharing associated
with opioid overdose reversal drugs to ensure that cost is not
a limiting factor for eligible patients.
(6) To conduct community outreach, in conjunction with
community-based organizations, designed to raise awareness of
co-prescribing practices, and the availability of opioid
overdose reversal drugs.
(7) To establish protocols to connect patients who have
experienced a drug overdose with appropriate treatment,
including medication assisted treatment and appropriate
counseling and behavioral therapies.
(d) Evaluations by Recipients.--As a condition of receipt of a
grant under this section, an eligible entity shall, for each year for
which the grant is received, submit to the Secretary of Health and
Human Services information on appropriate outcome measures specified by
the Secretary to assess the outcomes of the program funded by the
grant, including--
(1) the number of prescribers trained;
(2) the number of prescribers who have co-prescribed an
opioid overdose reversal drug to at least one patient;
(3) the total number of prescriptions written for opioid
overdose reversal drugs;
(4) the percentage of patients at elevated risk who
received a prescription for an opioid overdose reversal drug;
(5) the number of patients reporting use of an opioid
overdose reversal drug; and
(6) any other outcome measures that the Secretary deems
appropriate.
(e) Reports by Secretary.--For each year of the grant program under
this section, the Secretary of Health and Human Services shall submit
to the appropriate committees of the House of Representatives and of
the Senate a report aggregating the information received from the grant
recipients for such year under subsection (d) and evaluating the
outcomes achieved by the programs funded by grants made under this
section.
(f) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section and section 103 $4,000,000 for
each of fiscal years 2017 through 2021.
SEC. 103. OPIOID OVERDOSE REVERSAL CO-PRESCRIBING GUIDELINES.
(a) In General.--The Secretary of Health and Human Services shall
establish a grant program under which the Secretary shall award grants
to eligible State entities to develop opioid overdose reversal co-
prescribing guidelines.
(b) Eligible State Entities.--For purposes of subsection (a),
eligible State entities are State departments of health in conjunction
with State medical boards; city, county, and local health departments;
and community stakeholder groups involved in reducing opioid overdose
deaths.
(c) Administrative Provisions.--
(1) Grant amounts.--A grant made under this section may not
be for more than $200,000 per grant.
(2) Prioritization.--In awarding grants under this section,
the Secretary shall give priority to eligible State entities
which propose to base their guidelines on existing guidelines
on co-prescribing to speed enactment, including guidelines of--
(A) the Department of Veterans Affairs;
(B) nationwide medical societies, such as the
American Society of Addiction Medicine or the American
Medical Association; and
(C) the Centers for Disease Control and Prevention.
SEC. 104. SURVEILLANCE CAPACITY BUILDING.
(a) Program Authorized.--The Secretary of Health and Human
Services, acting through the Director of the Centers for Disease
Control and Prevention, shall award cooperative agreements or grants to
eligible entities to improve fatal and nonfatal drug overdose
surveillance and reporting capabilities, including--
(1) providing training to improve identification of drug
overdose as the cause of death by coroners and medical
examiners;
(2) establishing, in cooperation with the National Poison
Data System, coroners, and medical examiners, a comprehensive
national program for surveillance of, and reporting to an
electronic database on, drug overdose deaths in the United
States; and
(3) establishing, in cooperation with the National Poison
Data System, a comprehensive national program for surveillance
of, and reporting to an electronic database on, fatal and
nonfatal drug overdose occurrences, including epidemiological
and toxicologic analysis and trends.
(b) Eligible Entity.--To be eligible to receive a grant or
cooperative agreement under this section, an entity shall be--
(1) a State, local, or tribal government; or
(2) the National Poison Data System working in conjunction
with a State, local, or tribal government.
(c) Application.--
(1) In general.--An eligible entity desiring a grant or
cooperative agreement under this section shall submit to the
Secretary an application at such time, in such manner, and
containing such information as the Secretary may require.
(2) Contents.--An application described in paragraph (1)
shall include--
(A) a description of the activities to be funded
through the grant or cooperative agreement; and
(B) evidence that the eligible entity has the
capacity to carry out such activities.
(d) Report.--As a condition of receipt of a grant or cooperative
agreement under this section, an eligible entity shall agree to prepare
and submit, not later than 90 days after the end of the grant or
cooperative agreement period, a report to the Secretary describing the
results of the activities supported through the grant or cooperative
agreement.
(e) National Poison Data System.--In this section, the term
``National Poison Data System'' means the system operated by the
American Association of Poison Control Centers, in partnership with the
Centers for Disease Control and Prevention, for real-time local, State,
and national electronic reporting, and the corresponding database
network.
(f) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $5,000,000 for each of the
fiscal years 2017 through 2021.
TITLE II--CRISIS
SEC. 201. GRANTS TO SUPPORT SYRINGE EXCHANGE PROGRAMS.
(a) In General.--The Secretary of Health and Human Services may
award grants to State, local, and tribal governments and community
organizations to support syringe exchange programs.
(b) Use of Funds.--Grants under subsection (a) may be used to
support carrying out syringe exchange programs, including through--
(1) providing outreach, counseling, health education, case
management, syringe disposal, and other services as determined
appropriate by the Secretary of Health and Human Services; and
(2) providing technical assistance, including training and
capacity building, to assist the development and implementation
of syringe exchange programs.
(c) Authorization of Appropriations.--There is authorized to be
appropriated $15,000,000 for each of fiscal years 2017 through 2021 to
carry out this section, of which--
(1) at least 15 percent shall be for syringe exchange
programs that have been in operation for less than 3 years; and
(2) 5 percent shall be for technical assistance under
subsection (b)(2).
SEC. 202. GRANT PROGRAM TO REDUCE DRUG OVERDOSE DEATHS.
(a) Program Authorized.--The Secretary of Health and Human
Services, acting through the Administrator of the Substance Abuse and
Mental Health Services Administration, shall award grants or enter into
cooperative agreements with eligible entities to enable the eligible
entities to reduce deaths occurring from overdoses of drugs.
(b) Eligible Entities.--To be eligible to receive a grant or
cooperative agreement under this section, an entity shall be a
partnership between any of the following: a State, local, or tribal
government, a correctional institution, a law enforcement agency, a
community agency, a professional organization in the field of poison
control and surveillance, or a private nonprofit organization.
(c) Application.--
(1) In general.--An eligible entity desiring a grant or
cooperative agreement under this section shall submit to the
Secretary of Health and Human Services an application at such
time, in such manner, and containing such information as the
Secretary may require.
(2) Contents.--An application under paragraph (1) shall
include--
(A) a description of the activities to be funded
through the grant or cooperative agreement; and
(B) evidence that the eligible entity has the
capacity to carry out such activities.
(d) Priority.--In entering into grants and cooperative agreements
under subsection (a), the Secretary of Health and Human Services shall
give priority to eligible entities that--
(1) include a public health agency or community-based
organization; and
(2) have expertise in preventing deaths occurring from
overdoses of drugs in populations at high risk of such deaths.
(e) Eligible Activities.--As a condition of receipt of a grant or
cooperative agreement under this section, an eligible entity shall
agree to use the grant or cooperative agreement to do each of the
following:
(1) Purchase and distribute the drug naloxone or a
similarly effective medication.
(2) Carry out one or more of the following activities:
(A) Educating prescribers and pharmacists about
overdose prevention and naloxone prescription, or
prescriptions of a similarly effective medication.
(B) Training first responders, other individuals in
a position to respond to an overdose, and law
enforcement and corrections officials on the effective
response to individuals who have overdosed on drugs.
Training pursuant to this subparagraph may include any
activity that is educational, instructional, or
consultative in nature, and may include volunteer
training, awareness building exercises, outreach to
individuals who are at risk of a drug overdose, and
distribution of educational materials.
(C) Implementing and enhancing programs to provide
overdose prevention, recognition, treatment, and
response to individuals in need of such services.
(D) Educating the public and providing outreach to
the public about overdose prevention and naloxone
prescriptions, or prescriptions of other similarly
effective medications.
(f) Coordinating Center.--
(1) Establishment.--The Secretary of Health and Human
Services shall establish and provide for the operation of a
coordinating center responsible for--
(A) collecting, compiling, and disseminating data
on the programs and activities under this section,
including tracking and evaluating the distribution and
use of naloxone and other similarly effective
medication;
(B) evaluating such data and, based on such
evaluation, developing best practices for preventing
deaths occurring from drug overdoses;
(C) making such best practices specific to the type
of community involved;
(D) coordinating and harmonizing data collection
measures;
(E) evaluating the effects of the program on
overdose rates; and
(F) education and outreach to the public about
overdose prevention and prescription of naloxone and
other similarly effective medication.
(2) Reports to center.--As a condition on receipt of a
grant or cooperative agreement under this section, an eligible
entity shall agree to prepare and submit, not later than 90
days after the end of the award period, a report to such
coordinating center and the Secretary of Health and Human
Services describing the results of the activities supported
through the grant or cooperative agreement.
(g) Duration.--The period of a grant or cooperative agreement under
this section shall be 4 years.
(h) Definition.--In this part, the term ``drug''--
(1) means a drug, as defined in section 201 of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 321); and
(2) includes controlled substances, as defined in section
102 of the Controlled Substances Act (21 U.S.C. 802).
(i) Authorization of Appropriations.--There is authorized to be
appropriated $20,000,000 to carry out this section for each of the
fiscal years 2017 through 2021.
TITLE III--TREATMENT
SEC. 301. EXPANSION OF PATIENT LIMITS UNDER WAIVER.
Section 303(g)(2)(B) of the Controlled Substances Act (21 U.S.C.
823(g)(2)(B)) is amended--
(1) in clause (i), by striking ``physician'' and inserting
``practitioner'';
(2) in clause (iii)--
(A) by striking ``30'' and inserting ``100''; and
(B) by striking ``, unless, not sooner'' and all
that follows through the end and inserting a period;
and
(3) by inserting at the end the following new clause:
``(iv) Not earlier than 1 year after the date on
which a qualifying practitioner obtained an initial
waiver pursuant to clause (iii), the qualifying
practitioner may submit a second notification to the
Secretary of the need and intent of the qualifying
practitioner to treat an unlimited number of patients,
if the qualifying practitioner--
``(I)(aa) satisfies the requirements of
item (aa), (bb), (cc), or (dd) of subparagraph
(G)(ii)(I); and
``(bb) agrees to fully participate in the
Prescription Drug Monitoring Program of the
State in which the qualifying practitioner is
licensed, pursuant to applicable State
guidelines; or
``(II)(aa) satisfies the requirements of
item (ee), (ff), or (gg) of subparagraph
(G)(ii)(I);
``(bb) agrees to fully participate in the
Prescription Drug Monitoring Program of the
State in which the qualifying practitioner is
licensed, pursuant to applicable State
guidelines;
``(cc) practices in a qualified practice
setting; and
``(dd) has completed not less than 24 hours
of training (through classroom situations,
seminars at professional society meetings,
electronic communications, or otherwise) with
respect to the treatment and management of
opiate-dependent patients for substance use
disorders provided by the American Society of
Addiction Medicine, the American Academy of
Addiction Psychiatry, the American Medical
Association, the American Osteopathic
Association, the American Psychiatric
Association, or any other organization that the
Secretary determines is appropriate for
purposes of this subclause.''.
SEC. 302. DEFINITIONS.
Section 303(g)(2)(G) of the Controlled Substances Act (21 U.S.C.
823(g)(2)(G)) is amended--
(1) by striking clause (ii) and inserting the following:
``(ii) The term `qualifying practitioner' means the
following:
``(I) A physician who is licensed under
State law and who meets 1 or more of the
following conditions:
``(aa) The physician holds a board
certification in addiction psychiatry
from the American Board of Medical
Specialties.
``(bb) The physician holds an
addiction certification from the
American Society of Addiction Medicine.
``(cc) The physician holds a board
certification in addiction medicine
from the American Osteopathic
Association.
``(dd) The physician holds a board
certification from the American Board
of Addiction Medicine.
``(ee) The physician has completed
not less than 8 hours of training
(through classroom situations, seminar
at professional society meetings,
electronic communications, or
otherwise) with respect to the
treatment and management of opiate-
dependent patients for substance use
disorders provided by the American
Society of Addiction Medicine, the
American Academy of Addiction
Psychiatry, the American Medical
Association, the American Osteopathic
Association, the American Psychiatric
Association, or any other organization
that the Secretary determines is
appropriate for purposes of this
subclause.
``(ff) The physician has
participated as an investigator in 1 or
more clinical trials leading to the
approval of a narcotic drug in schedule
III, IV, or V for maintenance or
detoxification treatment, as
demonstrated by a statement submitted
to the Secretary by this sponsor of
such approved drug.
``(gg) The physician has such other
training or experience as the Secretary
determines will demonstrate the ability
of the physician to treat and manage
opiate-dependent patients.
``(II) A nurse practitioner or physician
assistant who is licensed under State law and
meets all of the following conditions:
``(aa) The nurse practitioner or
physician assistant is licensed under
State law to prescribe schedule III,
IV, or V medications for pain.
``(bb) The nurse practitioner or
physician assistant satisfies 1 or more
of the following:
``(AA) Has completed not
fewer than 24 hours of training
(through classroom situations,
seminar at professional society
meetings, electronic
communications, or otherwise)
with respect to the treatment
and management of opiate-
dependent patients for
substance use disorders
provided by the American
Society of Addiction Medicine,
the American Academy of
Addiction Psychiatry, the
American Medical Association,
the American Osteopathic
Association, the American
Psychiatric Association, or any
other organization that the
Secretary determines is
appropriate for purposes of
this subclause.
``(BB) Has such other
training or experience as the
Secretary determines will
demonstrate the ability of the
nurse practitioner or physician
assistant to treat and manage
opiate-dependent patients.
``(cc) The nurse practitioner or
physician assistant practices within
the scope of their State license,
including compliance with any
supervision or collaboration
requirements under State law.
``(dd) The nurse practitioner or
physician assistant practice in a
qualified practice setting.''; and
(2) by adding at the end the following:
``(iii) The term `qualified practice setting' means
1 or more of the following treatment settings:
``(I) A National Committee for Quality
Assurance-recognized Patient-Centered Medical
Home or Patient-Centered Specialty Practice.
``(II) A Centers for Medicaid & Medicare
Services-recognized Accountable Care
Organization.
``(III) A clinical facility administered by
the Department of Veterans Affairs, Department
of Defense, or Indian Health Service.
``(IV) A Behavioral Health Home accredited
by the Joint Commission.
``(V) A Federally-qualified health center
(as defined in section 1905(l)(2)(B) of the
Social Security Act (42 U.S.C. 1396d(l)(2)(B)))
or a Federally-qualified health center look-
alike.
``(VI) A Substance Abuse and Mental Health
Services-certified Opioid Treatment Program.
``(VII) A clinical program of a State or
Federal jail, prison, or other facility where
individuals are incarcerated.
``(VIII) A clinic that demonstrates
compliance with the Model Policy on DATA 2000
and Treatment of Opioid Addiction in the
Medical Office issued by the Federation of
State Medical Boards.
``(IX) A treatment setting that is part of
an Accreditation Council for Graduate Medical
Education, American Association of Colleges of
Osteopathic Medicine, or American Osteopathic
Association-accredited residency or fellowship
training program.
``(X) Any other practice setting approved
by a State regulatory board, State substance
abuse agency, or State Medicaid Plan to provide
addiction treatment services.
``(XI) Any other practice setting approved
by the Secretary.''.
SEC. 303. EVALUATION BY ASSISTANT SECRETARY FOR PLANNING AND
EVALUATION.
Two years after the date on which the first notification under
clause (iv) of section 303(g)(2)(B) of the Controlled Substances Act
(21 U.S.C. 823(g)(2)(B)), as added by section 301, is received by the
Secretary of Health and Human Services, the Assistant Secretary for
Planning and Evaluation shall initiate an evaluation of the
effectiveness of the amendments made by sections 301 and 302, which
shall include an evaluation of--
(1) any changes in the availability and use of medication-
assisted treatment for opioid addiction;
(2) the quality of medication-assisted treatment programs;
(3) the integration of medication-assisted treatment with
routine healthcare services;
(4) diversion of opioid addiction treatment medication;
(5) changes in State or local policies and legislation
relating to opioid addiction treatment;
(6) the use of nurse practitioners and physician assistants
who prescribe opioid addiction medication;
(7) the use of Prescription Drug Monitoring Programs by
waived practitioners to maximize safety of patient care and
prevent diversion of opioid addiction medication;
(8) the findings of the Drug Enforcement Administration
inspections of waived practitioners, including the frequency
with which the Drug Enforcement Administration finds no
documentation of access to behavioral health services; and
(9) the effectiveness of cross-agency collaboration between
the Department of Health and Human Services and the Drug
Enforcement Administration for expanding effective opioid
addiction treatment.
SEC. 304. REAUTHORIZATION OF RESIDENTIAL TREATMENT PROGRAMS FOR
PREGNANT AND POSTPARTUM WOMEN.
Section 508 of the Public Health Service Act (42 U.S.C. 290bb-1) is
amended--
(1) in subsection (p), by inserting ``(other than
subsection (r))'' after ``section''; and
(2) in subsection (r), by striking ``such sums'' and all
that follows through ``2003'' and inserting ``$40,000,000 for
each of fiscal years 2017 through 2021''.
SEC. 305. PILOT PROGRAM GRANTS FOR STATE SUBSTANCE ABUSE AGENCIES.
(a) In General.--From amounts made available under section 508(s)
of the Public Health Service Act (42 U.S.C. 290bb-1), the Secretary of
Health and Human Services (referred to in this section as the
``Secretary'') shall carry out a pilot program under which competitive
grants are made by the Secretary to State substance abuse agencies to--
(1) enhance flexibility in the use of funds designed to
support family-based services for pregnant and postpartum women
with a primary diagnosis of a substance use disorder, including
opioid use disorders;
(2) help State substance abuse agencies address identified
gaps in services furnished to such women along the continuum of
care, including services provided to women in nonresidential-
based settings; and
(3) promote a coordinated, effective, and efficient State
system managed by State substance abuse agencies by encouraging
new approaches and models of service delivery.
(b) Requirements.--In carrying out the pilot program under this
section, the Secretary shall--
(1) require State substance abuse agencies to submit to the
Secretary applications, in such form and manner and containing
such information as specified by the Secretary, to be eligible
to receive a grant under the program;
(2) identify, based on such submitted applications, State
substance abuse agencies that are eligible for such grants;
(3) require services proposed to be furnished through such
a grant to support family-based treatment and other services
for pregnant and postpartum women with a primary diagnosis of a
substance use disorder, including opioid use disorders; and
(4) not require that services furnished through such a
grant be provided solely to women that reside in facilities.
(c) Required Services.--
(1) In general.--The Secretary shall specify a minimum set
of services required to be made available to eligible women
through a grant awarded under the pilot program under this
section. Such minimum set--
(A) shall include requirements described in section
508(c) of the Public Health Service Act and be based on
the recommendations submitted under paragraph (2); and
(B) may be selected from among the services
described in section 508(d) of such Act and include
other services as appropriate.
(2) Stakeholder input.--The Secretary shall convene and
solicit recommendations from stakeholders, including State
substance abuse agencies, health care providers, persons in
recovery from substance abuse, and other appropriate
individuals, for the minimum set of services described in
paragraph (1).
(d) Duration.--The pilot program under this section shall not
exceed 5 years.
(e) Evaluation and Report to Congress.--The Director of the Center
for Behavioral Health Statistics and Quality shall fund an evaluation
of the pilot program at the conclusion of the first grant cycle funded
by the pilot program. The Director of the Center for Behavioral Health
Statistics and Quality, in coordination with the Secretary shall submit
to the relevant committees of jurisdiction of the House of
Representatives and the Senate a report on such evaluation. The report
shall include at a minimum outcomes information from the pilot program,
including any resulting reductions in the use of alcohol and other
drugs; engagement in treatment services; retention in the appropriate
level and duration of services; increased access to the use of
medications approved by the Food and Drug Administration for the
treatment of substance use disorders in combination with counseling;
and other appropriate measures.
(f) State Substance Abuse Agencies Defined.--For purposes of this
section, the term ``State substance abuse agency'' means, with respect
to a State, the agency in such State that manages the Substance Abuse
Prevention and Treatment Block Grant under part B of title XIX of the
Public Health Service Act.
(g) Funding.--Subsection (s) of section 508 of the Public Health
Service Act (42 U.S.C. 290bb-1), is amended by adding at the end the
following new sentence: ``Of the amounts made available for a year
pursuant to the previous sentence to carry out this section, not more
than 25 percent of such amounts shall be made available for such year
to carry out section 305 of the Heroin and Prescription Drug Abuse
Prevention and Reduction Act, other than subsection (e) of such
section.''.
SEC. 306. EVIDENCE-BASED OPIOID AND HEROIN TREATMENT AND INTERVENTIONS
DEMONSTRATION.
(a) Grants.--
(1) Authority to make grants.--The Secretary of Health and
Human Services (referred to in this section as the
``Secretary'') shall award grants to State substance abuse
agencies, units of local government, nonprofit organizations,
and Indian tribes or tribal organizations (as defined in
section 4 of the Indian Health Care Improvement Act (25 U.S.C.
1603)) that have a high rate, or have had a rapid increase, in
the use of heroin or other opioids, in order to permit such
entities to expand activities, including an expansion in the
availability of medication assisted treatment, evidence-based
counseling, or behavioral therapies with respect to the
treatment of addiction in the specific geographical areas of
such entities where there is a rate or rapid increase in the
use of heroin or other opioids.
(2) Recipients.--The entities receiving grants under
paragraph (1) shall be selected by the Secretary.
(3) Nature of activities.--The grant funds awarded under
paragraph (1) shall be used for activities that are based on
reliable scientific evidence of efficacy in the treatment of
problems related to heroin or other opioids.
(b) Geographic Distribution.--The Secretary shall ensure that
grants awarded under subsection (a) are distributed equitably among the
various regions of the Nation and among rural, urban, and suburban
areas that are affected by the use of heroin or other opioids.
(c) Additional Activities.--The Secretary shall--
(1) evaluate the activities supported by grants awarded
under subsection (a);
(2) disseminate widely such significant information derived
from the evaluation as the Secretary considers appropriate;
(3) provide States, Indian tribes and tribal organizations,
and providers with technical assistance in connection with the
provision of treatment of problems related to heroin and other
opioids; and
(4) fund only those applications that specifically support
recovery services as a critical component of the grant program.
(d) Definition.--In this section, the term ``medication assisted
treatment'' means the use, for problems relating to heroin and other
opioids, of medications approved by the Food and Drug Administration in
combination with counseling and behavioral therapies.
(e) Authorization of Appropriations.--
(1) In general.--There is authorized to be appropriated to
carry out this section $300,000,000 for each of fiscal years
2017 through 2021.
(2) Use of certain funds.--Of the funds appropriated to
carry out this section in any fiscal year, not more than 5
percent of such funds shall be available to the Secretary for
purposes of carrying out subsection (c).
SEC. 307. GRANTS TO IMPROVE ACCESS TO TREATMENT AND RECOVERY FOR
ADOLESCENTS.
(a) In General.--The Secretary of Health and Human Services
(referred to in this section as the ``Secretary'') shall award grants,
contracts, or cooperative agreements to eligible State substance abuse
agencies and other entities determined appropriate by the Secretary for
the purpose of increasing the capacity of substance use disorder
treatment and recovery services for adolescents.
(b) Eligibility.--To be eligible to receive a grant, contract, or
cooperative agreement under subsection (a) an entity shall--
(1) prepare and submit to the Secretary an application at
such time, in such manner, and contain such information as the
Secretary may require, including a plan for the evaluation of
any activities carried out with the funds provided under this
section;
(2) ensure that all entities receiving support under the
grant, contract, or cooperative agreement comply with all
applicable State licensure or certification requirements
regarding the provision of the services involved; and
(3) provide the Secretary with periodic evaluations of the
progress of the activities funded under this section and an
evaluation at the completion of such activities, as the
Secretary determines to be appropriate.
(c) Priority.--In awarding grants, contracts, and cooperative
agreements under subsection (a), the Secretary shall give priority to
applicants who propose to fill a demonstrated geographic need for
adolescent specific residential treatment services.
(d) Use of Funds.--Amounts awarded under grants, contracts, or
cooperative agreements under this section may be used to enable health
care providers or facilities that provide treatment and recovery
assistance for adolescents with a substance use disorder to provide the
following services:
(1) Individualized patient centered care that is specific
to circumstances of the individual patient.
(2) Clinically appropriate, trauma-informed, gender-
specific and age appropriate treatment services that are based
on reliable scientific evidence of efficacy in the treatment of
problems related to substance use disorders.
(3) Clinically appropriate care to address treatment for
substance use and any co-occurring physical and mental health
disorders at the same location, and through access to primary
care services.
(4) Coordination of treatment services with recovery and
other social support, including educational, vocational
training, assistance with the juvenile justice system, child
welfare, and mental health agencies.
(5) Aftercare and long-term recovery support, including
peer support services.
(e) Duration of Assistance.--Grants, contracts, and cooperative
agreements awarded under subsection (a) shall be for a period not to
exceed 5 years.
(f) Additional Activities.--The Secretary shall--
(1) collect and evaluate the activities carried out with
amounts received under subsection (a);
(2) disseminate widely such significant information derived
from the evaluation as the Secretary considers appropriate; and
(3) provide States, Indian tribes and tribal organizations,
and providers with technical assistance in connection with the
provision of treatment and recovery services funded through
this section to adolescents related to the abuse of heroin and
other opioids.
(g) Authorization of Appropriations.--
(1) In general.--There is authorized to be appropriated to
carry out this section, $25,000,000 for each of fiscal years
2017 through 2021.
(2) Use of certain funds.--Of the funds appropriated to
carry out this section in any fiscal year, not more than 5
percent of such funds shall be available to the Secretary for
purposes of carrying out subsection (f).
SEC. 308. STRENGTHENING PARITY IN MENTAL HEALTH AND SUBSTANCE USE
DISORDER BENEFITS.
(a) Public Health Service Act.--Section 2726(a) of the Public
Health Service Act (42 U.S.C. 300gg-26(a)) is amended by adding at the
end the following new paragraphs:
``(6) Disclosure and enforcement requirements.--
``(A) Disclosure requirements.--
``(i) Regulations.--Not later than December
31, 2016, the Secretary, in cooperation with
the Secretaries of Labor and the Treasury, as
appropriate, shall issue additional regulations
for carrying out this section, including an
explanation of documents that must be disclosed
by plans and issuers, the process governing
such disclosures by plans and issuers, and
analyses that must be conducted by plans and
issuers by a group health plan or health
insurance issuer offering health insurance
coverage in the group or individual market in
order for such plan or issuer to demonstrate
compliance with the provisions of this section.
``(ii) Disclosure requirements.--Documents
required to be disclosed by a group health plan
or health insurance issuer offering health
insurance coverage in the group or individual
market under clause (i) shall include an annual
report that details the specific analyses
performed to ensure compliance of such plan or
coverage with the law and regulations. At a
minimum, with respect to the application of
non-quantitative treatment limitations (in this
paragraph referred to as NQTLs) to benefits
under the plan or coverage, such report shall--
``(I) identify the specific factors
the plan or coverage used in performing
its NQTL analysis;
``(II) identify and define the
specific evidentiary standards relied
on to evaluate the factors;
``(III) describe how the
evidentiary standards are applied to
each service category for mental
health, substance use disorders,
medical benefits, and surgical
benefits;
``(IV) disclose the results of the
analyses of the specific evidentiary
standards in each service category; and
``(V) disclose the specific
findings of the plan or coverage in
each service category and the
conclusions reached with respect to
whether the processes, strategies,
evidentiary standards, or other factors
used in applying the NQTL to mental
health or substance use disorder
benefits are comparable to, and applied
no more stringently than, the
processes, strategies, evidentiary
standards, or other factors used in
applying the limitation with respect to
medical and surgical benefits in the
same classification.
``(iii) Guidance.--The Secretary, in
cooperation with the Secretaries of Labor and
the Treasury, as appropriate, shall issue
guidance to group health plans and health
insurance issuers offering health insurance
coverage in the group or individual markets on
how to satisfy the requirements of this section
with respect to making information available to
current and potential participants and
beneficiaries. Such information shall include
certificate of coverage documents and
instruments under which the plan or coverage
involved is administered and operated that
specify, include, or refer to procedures,
formulas, and methodologies applied to
determine a participant or beneficiary's
benefit under the plan or coverage, regardless
of whether such information is contained in a
document designated as the `plan document'.
Such guidance shall include a disclosure of how
the plan or coverage involved has provided that
processes, strategies, evidentiary standards,
and other factors used in applying the NQTL to
mental health or substance use disorder
benefits are comparable to, and applied no more
stringently than, the processes, strategies,
evidentiary standards, or other factors used in
applying the limitation with respect to medical
and surgical benefits in the same
classification.
``(iv) Definitions.--In this paragraph and
paragraph (7), the terms `non-quantitative
treatment limitations', `comparable to', and
`applied no more stringently than' have the
meanings given such terms in sections 146 and
147 of title 45, Code of Federal Regulations
(or any successor regulation).
``(B) Enforcement.--
``(i) Process for complaints.--The
Secretary, in cooperation with the Secretaries
of Labor and the Treasury, as appropriate,
shall, with respect to group health plans and
health insurance issuers offering health
insurance coverage in the group or individual
market, issue guidance to clarify the process
and timeline for current and potential
participants and beneficiaries (and authorized
representatives and health care providers of
such participants and beneficiaries) with
respect to such plans and coverage to file
formal complaints of such plans or issuers
being in violation of this section, including
guidance, by plan type, on the relevant State,
regional, and national offices with which such
complaints should be filed.
``(ii) Authority for public enforcement.--
The Secretary, in consultation with the
Secretaries of Labor and the Treasury, shall
make available to the public on the Consumer
Parity Portal website established under
paragraph (7) de-identified information on
audits and investigations of group health plans
and health insurance issuers conducted under
this section.
``(iii) Audits.--
``(I) Randomized audits.--The
Secretary in cooperation with the
Secretaries of Labor and the Treasury,
is authorized to conduct randomized
audits of group health plans and health
insurance issuers offering health
insurance coverage in the group or
individual market to determine
compliance with this section. Such
audits shall be conducted on no fewer
than twelve plans and issuers per plan
year. Information from such audits
shall be made plainly available on the
Consumer Parity Portal website
established under paragraph (7).
``(II) Additional audits.--In the
case of a group health plan or health
insurance issuer offering health
insurance coverage in the group or
individual market with respect to which
any claim has been filed during a plan
year, the Secretary may audit the books
and records of such plan or issuer to
determine compliance with this section.
Information detailing the results of
the audit shall be made available on
the Consumer Parity Portal website
established under paragraph (7).
``(iv) Denial rates.--The Secretary shall
collect information on the rates of and reasons
for denial by group health plans and health
insurance issuers offering health insurance
coverage in the group or individual market of
claims for outpatient and inpatient mental
health and substance use disorder services
compared to the rates of and reasons for denial
of claims for medical and surgical services.
For the first plan year beginning at least two
years after the date of the enactment of this
paragraph and each subsequent plan year, the
Secretary shall submit to the Committee on
Energy and Commerce of the House of
Representatives and the Committee on Health,
Education, Labor, and Pensions of the Senate,
and make plainly available on the Consumer
Parity Portal website under paragraph (7), the
information collected under the previous
sentence with respect to the previous plan
year.
``(7) Consumer parity portal website.--The Secretary, in
consultation with the Secretaries of Labor and the Treasury,
shall establish a one-stop Internet website portal for--
``(A) submitting complaints and violations relating
to this section, section 712 of the Employee Retirement
Income Security Act of 1974, and section 9812 of the
Internal Revenue Code of 1986; and
``(B) for each of such Secretaries to submit
information in order to provide such information to
health care consumers pursuant to paragraph (6),
section 712(a)(6) of the Employee Retirement Income
Security Act of 1974, and section 9812(a)(6) of the
Internal Revenue Code of 1986.
Such portal shall have the ability to take basic information
related to the complaint, including name, contact information,
and brief narrative, and transmit such information in a timely
fashion to the appropriate State or Federal enforcement agency.
Once the consumer information is submitted, such portal shall
provide the consumer with contact information for the
appropriate enforcement agency to follow-up on the
complaint.''.
(b) Employee Retirement Income Security Act of 1974.--Section
712(a) of the Employee Retirement Income Security Act of 1974 (29
U.S.C. 1185a(a)) is amended by adding at the end the following new
paragraph:
``(6) Disclosure and enforcement requirements.--
``(A) Disclosure requirements.--
``(i) Regulations.--Not later than December
31, 2016, the Secretary, in cooperation with
the Secretaries of Health and Human Services
and the Treasury, as appropriate, shall issue
additional regulations for carrying out this
section, including an explanation of documents
that must be disclosed by plans and issuers,
the process governing such disclosures by plans
and issuers, and analyses that must be
conducted by plans and issuers by a group
health plan (or health insurance coverage
offered in connection with such a plan) in
order for such plan or issuer to demonstrate
compliance with the provisions of this section.
``(ii) Disclosure requirements.--Documents
required to be disclosed by a group health plan
(or health insurance coverage offered in
connection with such a plan) under clause (i)
shall include an annual report that details the
specific analyses performed to ensure
compliance of such plan or coverage with the
law or regulations. At a minimum, with respect
to the application of non-quantitative
treatment limitations (in this paragraph
referred to as NQTLs) to benefits under the
plan or coverage, such report shall--
``(I) identify the specific factors
the plan or coverage used in performing
its NQTL analysis;
``(II) identify and define the
specific evidentiary standards relied
on to evaluate the factors;
``(III) describe how the
evidentiary standards are applied to
each service category for mental
health, substance use disorders,
medical benefits, and surgical
benefits;
``(IV) disclose the results of the
analyses of the specific evidentiary
standards in each service category; and
``(V) disclose the specific
findings of the plan or coverage in
each service category and the
conclusions reached with respect to
whether the processes, strategies,
evidentiary standards, or other factors
used in applying the NQTL to mental
health or substance use disorder
benefits are comparable to, and applied
no more stringently than, the
processes, strategies, evidentiary
standards, or other factors used in
applying the limitation with respect to
medical and surgical benefits in the
same classification.
``(iii) Guidance.--The Secretary, in
cooperation with the Secretaries of Health and
Human Services and the Treasury, as
appropriate, shall issue guidance to group
health plans (and health insurance coverage
offered in connection with such a plan) on how
to satisfy the requirements of this section
with respect to making information available to
current and potential participants and
beneficiaries. Such information shall include
certificate of coverage documents and
instruments under which the plan or coverage
involved is administered and operated that
specify, include, or refer to procedures,
formulas, and methodologies applied to
determine a participant or beneficiary's
benefit under the plan or coverage, regardless
of whether such information is contained in a
document designated as the `plan document'.
Such guidance shall include a disclosure of how
the plan or coverage involved has provided that
processes, strategies, evidentiary standards,
and other factors used in applying the NQTL to
mental health or substance use disorder
benefits are comparable to, and applied no more
stringently than, the processes, strategies,
evidentiary standards, or other factors used in
applying the limitation with respect to medical
and surgical benefits in the same
classification.
``(iv) Definitions.--In this paragraph, the
terms `non-quantitative treatment limitations',
`comparable to', and `applied no more
stringently than' have the meanings given such
terms in sections 146 and 147 of title 45, Code
of Federal Regulations (or any successor
regulation).
``(B) Enforcement.--
``(i) Process for complaints.--The
Secretary, in cooperation with the Secretaries
of Health and Human Services and the Treasury,
as appropriate, shall, with respect to group
health plans (and health insurance coverage
offered in connection with such a plan), issue
guidance to clarify the process and timeline
for current and potential participants and
beneficiaries (and authorized representatives
and health care providers of such participants
and beneficiaries) with respect to such plans
(and coverage) to file formal complaints of
such plans (or coverage) being in violation of
this section, including guidance, by plan type,
on the relevant State, regional, and national
offices with which such complaints should be
filed.
``(ii) Authority for public enforcement.--
The Secretary, in consultation with the
Secretaries of Labor and the Treasury, shall
make available to the public on the Consumer
Parity Portal website established under section
2726(a)(7) of the Public Health Service Act de-
identified information on audits and
investigations of group health plans (and
health insurance coverage offered in connection
with such a plan) conducted under this section.
``(iii) Audits.--
``(I) Randomized audits.--The
Secretary in cooperation with the
Secretaries of Health and Human
Services and the Treasury, is
authorized to conduct randomized audits
of group health plans (and health
insurance coverage offered in
connection with such a plan) to
determine compliance with this section.
Such audits shall be conducted on no
fewer than twelve plans and coverage
per plan year. Information from such
audits shall be made plainly available
on the Consumer Parity Portal website
established under section 2726(a)(7) of
the Public Health Service Act.
``(II) Additional audits.--In the
case of a group health plan (or health
insurance coverage offered in
connection with such a plan) with
respect to which any claim has been
filed during a plan year, the Secretary
may audit the books and records of such
plan (or coverage) to determine
compliance with this section.
Information detailing the results of
the audit shall be made available on
the Consumer Parity Portal website
established under section 2726(a)(7) of
the Public Health Service Act.
``(iv) Denial rates.--The Secretary shall
collect information on the rates of and reasons
for denial by group health plans (and health
insurance coverage offered in connection with
such a plan) of claims for outpatient and
inpatient mental health and substance use
disorder services compared to the rates of and
reasons for denial of claims for medical and
surgical services. For the first plan year
beginning at least two years after the date of
the enactment of this paragraph and each
subsequent plan year, the Secretary shall
submit to the Committee on Energy and Commerce
of the House of Representatives and the
Committee on Health, Education, Labor, and
Pensions of the Senate, and make plainly
available on the Consumer Parity Portal website
under section 2726(a)(7) of the Public Health
Service Act, the information collected under
the previous sentence with respect to the
previous plan year.''.
(c) Internal Revenue Code of 1986.--Section 9812(a) of the Internal
Revenue Code of 1986 is amended by adding at the end the following new
paragraph:
``(6) Disclosure and enforcement requirements.--
``(A) Disclosure requirements.--
``(i) Regulations.--Not later than December
31, 2016, the Secretary, in cooperation with
the Secretaries of Health and Human Services
and Labor, as appropriate, shall issue
additional regulations for carrying out this
section, including an explanation of documents
that must be disclosed by plans and issuers,
the process governing such disclosures by plans
and issuers, and analyses that must be
conducted by plans and issuers by a group
health plan in order for such plan to
demonstrate compliance with the provisions of
this section.
``(ii) Disclosure requirements.--Documents
required to be disclosed by a group health plan
under clause (i) shall include an annual report
that details the specific analyses performed to
ensure compliance of such plan with the law and
regulations. At a minimum, with respect to the
application of non-quantitative treatment
limitations (in this paragraph referred to as
NQTLs) to benefits under the plan or coverage,
such report shall--
``(I) identify the specific factors
the plan or coverage used in performing
its NQTL analysis;
``(II) identify and define the
specific evidentiary standards relied
on to evaluate the factors;
``(III) describe how the
evidentiary standards are applied to
each service category for mental
health, substance use disorders,
medical benefits, and surgical
benefits;
``(IV) disclose the results of the
analyses of the specific evidentiary
standards in each service category; and
``(V) disclose the specific
findings of the plan in each service
category and the conclusions reached
with respect to whether the processes,
strategies, evidentiary standards, or
other factors used in applying the NQTL
to mental health or substance use
disorder benefits are comparable to,
and applied no more stringently than,
the processes, strategies, evidentiary
standards, or other factors used in
applying the limitation with respect to
medical and surgical benefits in the
same classification.
``(iii) Guidance.--The Secretary, in
cooperation with the Secretaries of Health and
Human Services and Labor, as appropriate, shall
issue guidance to group health plans on how to
satisfy the requirements of this section with
respect to making information available to
current and potential participants and
beneficiaries. Such information shall include
certificate of coverage documents and
instruments under which the plan involved is
administered and operated that specify,
include, or refer to procedures, formulas, and
methodologies applied to determine a
participant or beneficiary's benefit under the
plan, regardless of whether such information is
contained in a document designated as the `plan
document'. Such guidance shall include a
disclosure of how the plan involved has
provided that processes, strategies,
evidentiary standards, and other factors used
in applying the NQTL to mental health or
substance use disorder benefits are comparable
to, and applied no more stringently than, the
processes, strategies, evidentiary standards,
or other factors used in applying the
limitation with respect to medical and surgical
benefits in the same classification.
``(iv) Definitions.--In this paragraph, the
terms `non-quantitative treatment limitations',
`comparable to', and `applied no more
stringently than' have the meanings given such
terms in sections 146 and 147 of title 45, Code
of Federal Regulations (or any successor
regulation).
``(B) Enforcement.--
``(i) Process for complaints.--The
Secretary, in cooperation with the Secretaries
of Health and Human Services and Labor, as
appropriate, shall, with respect to group
health plans, issue guidance to clarify the
process and timeline for current and potential
participants and beneficiaries (and authorized
representatives and health care providers of
such participants and beneficiaries) with
respect to such plans (and coverage) to file
formal complaints of such plans being in
violation of this section, including guidance,
by plan type, on the relevant State, regional,
and national offices with which such complaints
should be filed.
``(ii) Authority for public enforcement.--
The Secretary, in consultation with the
Secretaries of Labor and the Treasury, shall
make available to the public on the Consumer
Parity Portal website established under section
2726(a)(7) of the Public Health Service Act de-
identified information on audits and
investigations of group health plans conducted
under this section.
``(iii) Audits.--
``(I) Randomized audits.--The
Secretary in cooperation with the
Secretaries of Health and Human
Services and Labor, is authorized to
conduct randomized audits of group
health plans to determine compliance
with this section. Such audits shall be
conducted on no fewer than twelve plans
per plan year. Information from such
audits shall be made plainly available
on the Consumer Parity Portal website
established under section 2726(a)(7) of
the Public Health Service Act.
``(II) Additional audits.--In the
case of a group health plan with
respect to which any claim has been
filed during a plan year, the Secretary
may audit the books and records of such
plan to determine compliance with this
section. Information detailing the
results of the audit shall be made
available on the Consumer Parity Portal
website established under section
2726(a)(7) of the Public Health Service
Act.
``(iv) Denial rates.--The Secretary shall
collect information on the rates of and reasons
for denial by group health plans of claims for
outpatient and inpatient mental health and
substance use disorder services compared to the
rates of and reasons for denial of claims for
medical and surgical services. For the first
plan year beginning at least two years after
the date of the enactment of this paragraph and
each subsequent plan year, the Secretary shall
submit to the Committee on Energy and Commerce
of the House of Representatives and the
Committee on Health, Education, Labor, and
Pensions of the Senate, and make plainly
available on the Consumer Parity Portal website
under section 2726(a)(7) of the Public Health
Service Act, the information collected under
the previous sentence with respect to the
previous plan year.''.
(d) Authorization of Appropriations.--There is authorized to be
appropriated $2,000,000 for each of fiscal years 2017 through 2021 to
carry out this section, including the amendments made by this section.
SEC. 309. STUDY ON TREATMENT INFRASTRUCTURE.
Not later than 24 months after the date of enactment of this Act,
the Comptroller General of the United States shall initiate an
evaluation, and submit to Congress a report, of the inpatient and
outpatient treatment capacity, availability, and needs of the United
States, which shall include, to the extent data is available--
(1) the capacity of acute residential or inpatient
detoxification programs;
(2) the capacity of inpatient clinical stabilization
programs, transitional residential support services, and
residential rehabilitation programs;
(3) the capacity of demographic specific residential or
inpatient treatment programs, such as those designed for
pregnant women or adolescents;
(4) geographical differences of the availability of
residential and outpatient treatment and recovery options for
substance use disorders across the continuum of care;
(5) the availability of residential and outpatient
treatment programs that offer treatment options based on
reliable scientific evidence of efficacy for the treatment of
substance use disorders, including the use of Food and Drug
Administration-approved medicines and evidence-based
nonpharmacological therapies;
(6) the number of patients in residential and specialty
outpatient treatment services for substance use disorders; and
(7) an assessment of the need for residential and
outpatient treatment for substance use disorders across the
continuum of care.
SEC. 310. SUBSTANCE USE DISORDER PROFESSIONAL LOAN REPAYMENT PROGRAM.
Subpart 3 of part E of title VII of the Public Health Service Act
(42 U.S.C. 295f et seq.) is amended by adding at the end the following:
``SEC. 779. SUBSTANCE USE DISORDER PROFESSIONAL LOAN REPAYMENT PROGRAM.
``(a) Establishment.--The Secretary shall establish and carry out a
substance use disorder health professional loan repayment program under
which qualified health professionals agree to be employed full-time for
a specified period (which shall be not less than 2 years) in providing
substance use disorder prevention and treatment services.
``(b) Program Administration.--Through the program established
under this section, the Secretary shall enter into contracts with
qualified health professionals under which--
``(1) a qualified health professional agrees to provide
substance use disorder prevention and treatment services with
respect to an area or population that (as determined by the
Secretary)--
``(A) has a shortage of such services (as defined
by the Secretary); and
``(B) has a sufficient population of individuals
with a substance use disorder to support the provision
of such services; and
``(2) the Secretary agrees to make payments on the
principal and interest of undergraduate, or graduate education
loans of the qualified health professional--
``(A) of not more than $35,000 for each year of
service described in paragraph (1); and
``(B) for not more than 3 years.
``(c) Qualified Health Professional Defined.--In this section, the
term `qualified health professional' means an individual who is (or
will be upon the completion of the individual's graduate education) a
psychiatrist, psychologist, nurse practitioner, physician assistant,
clinical social worker, substance abuse counselor, or other substance
use disorder health professional.
``(d) Priority.--In entering into agreements under this section,
the Secretary shall give priority to applicants who--
``(1) have familiarity with evidence-based methods and
culturally and linguistically competent health care services;
and
``(2) demonstrate financial need.
``(e) Authorization of Appropriations.--There is authorized to be
appropriated $20,000,000 for each of fiscal years 2017 through 2021 to
carry out this section.''.
TITLE IV--RECOVERY
SEC. 401. NATIONAL YOUTH RECOVERY INITIATIVE.
(a) Definitions.--In this section:
(1) Eligible entity.--The term ``eligible entity'' means--
(A) a high school that has been accredited as a
recovery high school by the Association of Recovery
Schools;
(B) an accredited high school that is seeking to
establish or expand recovery support services;
(C) an institution of higher education;
(D) a recovery program at a nonprofit collegiate
institution; or
(E) a nonprofit organization.
(2) Institution of higher education.--The term
``institution of higher education'' has the meaning given the
term in section 101 of the Higher Education Act of 1965 (20
U.S.C. 1001).
(3) Recovery program.--The term ``recovery program''--
(A) means a program to help individuals who are
recovering from substance use disorders to initiate,
stabilize, and maintain healthy and productive lives in
the community; and
(B) includes peer-to-peer support and communal
activities to build recovery skills and supportive
social networks.
(4) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(b) Grants Authorized.--The Secretary, in consultation with the
Secretary of Education, may award grants to eligible entities to enable
the entities to--
(1) provide substance use recovery support services to
young people in high school and enrolled in institutions of
higher education;
(2) help build communities of support for young people in
recovery through a spectrum of activities such as counseling
and healthy and wellness-oriented social activities; and
(3) encourage initiatives designed to help young people
achieve and sustain recovery from substance use disorders.
(c) Use of Funds.--Grants awarded under subsection (b) may be used
for activities to develop, support, and maintain youth recovery support
services, including--
(1) the development and maintenance of a dedicated physical
space for recovery programs;
(2) dedicated staff for the provision of recovery programs;
(3) healthy and wellness-oriented social activities and
community engagement;
(4) establishment of recovery high schools;
(5) coordination of recovery programs with--
(A) substance use disorder treatment programs and
systems;
(B) providers of mental health services;
(C) primary care providers;
(D) the criminal justice system, including the
juvenile justice system;
(E) employers;
(F) housing services;
(G) child welfare services;
(H) institutions of secondary higher education and
institutions of higher education; and
(I) other programs or services related to the
welfare of an individual in recovery from a substance
use disorder;
(6) the development of peer-to-peer support programs or
services; and
(7) additional activities that help youths and young adults
to achieve recovery from substance use disorders.
(d) Technical Support.--The Secretary shall provide technical
support to recipients of grants under this section.
(e) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $30,000,000 for each of fiscal
years 2017 through 2021.
SEC. 402. GRANTS TO ENHANCE AND EXPAND RECOVERY SUPPORT SERVICES.
(a) In General.--The Secretary of Health and Human Services
(referred to in this section as the ``Secretary'') shall award grants
to State substance abuse agencies and nonprofit organizations to
develop, expand, and enhance recovery support services for individuals
with substance use disorders.
(b) Eligible Entities.--In the case of an applicant that is not a
State substance abuse agency, to be eligible to receive a grant under
this section, the entity shall--
(1) prepare and submit to the Secretary an application at
such time, in such manner, and contain such information as the
Secretary may require, including a plan for the evaluation of
any activities carried out with the funds provided under this
section;
(2) demonstrate the inclusion of individuals in recovery
from a substance use disorder in leadership levels or governing
bodies of the entity;
(3) have as a primary mission the provision of long-term
recovery support for substance use disorders; and
(4) be accredited by the Council on the Accreditation of
Peer Recovery Support Services or meet any applicable State
certification requirements regarding the provision of the
recovery services involved.
(c) Use of Funds.--Amounts awarded under a grant under this section
shall be used to provide for the following activities:
(1) Educating and mentoring that assists individuals and
families with substance use disorders in navigating systems of
care.
(2) Peer recovery support services which include peer
coaching and mentoring.
(3) Recovery-focused community education and outreach
programs, including training on the use of all forms of opioid
overdose antagonists used to counter the effects of an
overdose.
(4) Training, mentoring, and education to develop and
enhance peer mentoring and coaching.
(5) Programs aimed at identifying and reducing stigma and
discriminatory practices that serve as barriers to substance
use disorder recovery and treatment of these disorders.
(6) Developing partnerships between networks that support
recovery and other community organizations and services,
including--
(A) public and private substance use disorder
treatment programs and systems;
(B) health care providers;
(C) recovery-focused addiction and recovery
professionals;
(D) faith-based organizations;
(E) organizations focused on criminal justice
reform;
(F) schools; and
(G) social service agencies in the community,
including educational, juvenile justice, child welfare,
housing, and mental health agencies.
(d) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $100,000,000 for each of fiscal
years 2017 through 2021.
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